Prime Minister Sir Keir Starmer has announced that NHS England (NHSE) will be disbanded, marking a significant shift in the UK’s healthcare system. The move, supported by Health Secretary Wes Streeting, aims to decentralize control and empower frontline NHS leaders. However, healthcare experts and patient advocacy groups remain divided on whether this reorganization will truly enhance patient safety.
NHSE Criticized for Stifling Local NHS Trusts
For years, NHS trusts have expressed frustration over NHSE’s central control, which limited their ability to innovate and respond effectively to local challenges. A senior NHS official remarked, “You won’t find many shedding a tear over its demise, but there is concern over what this means for patient care.”
Streeting echoed these sentiments, stating that scrapping NHSE would “end the infantilization of frontline NHS leaders.”
Patient Safety Failures Under NHS England
Critics argue that NHSE has often prioritized protecting the NHS brand over addressing serious patient safety failures. Several high-profile maternity scandals—including those in Shrewsbury and Telford, East Kent, and Nottingham—were only exposed due to persistent campaigning by grieving families.
An inquiry into East Kent Hospitals University NHS Trust found that at least 45 babies could have survived with better care between 2009 and 2020. Despite NHSE being aware of concerns since 2013, it failed to act decisively, allowing preventable deaths to continue.
Helen Gittos, who lost her daughter at East Kent, welcomed NHSE’s abolition. “It’s as if they never even read the reports on maternity safety,” she said.
A Culture of Secrecy and Control
Experts argue that NHSE’s bureaucratic culture hindered transparency. Unlike individual NHS trusts, which publish board papers ahead of meetings, NHSE historically withheld documents until after discussions took place.
Longtime patient safety advocate Peter Walsh criticized NHSE’s approach, stating, “There are well-meaning people in NHSE, but they rarely saw it as their role to stand up for patients.”
A key example of this control was NHSE’s attempt to hire “independent” maternity safety advocates—a move that, according to critics, completely undermined their independence.
Will Abolishing NHS England Improve Patient Safety?
The dissolution of NHSE presents both risks and opportunities. Paul Whiting, CEO of Action Against Medical Accidents, warned that “in the short term, reorganization could set patient safety back.” However, he stressed that long-term reforms must prioritize patient well-being.
Professor James Walker, who led the Healthcare Safety Investigation Branch, believes the change is a crucial opportunity to refocus on patient-centered care. “We’ve lost empathy for patients—we need to focus on how we can help, rather than just following rigid NHS frameworks,” he said.
The government now faces a critical test: Can it create a new system that truly prioritizes patient safety, transparency, and accountability?
NHS England has been approached for comment.
